Guest guest Posted October 28, 1999 Report Share Posted October 28, 1999 I did not mean to imply that it should not be given ETT when nebulized-I have done this many times and it works quite well. What I was stressing was that when given as a bolus drug like the other " LEAN " drugs, it is of little efficacy due to the absorption in the upper airway. It is also true that any of the nebulized medications are going to be partially absorbed in the mucous membranes of te mouth and nose and all the way down. The ideal is that at least some of it will reach the lower airways and be effective. It is questionable, however, that a person in severe respiratory distress will be able to effectively inhale deep enough for the medication to reach these areas. In these types of cases in the past I have " assisted " the ventilations with the patients awake by BVM with in-line nebulizer. I am not sure how dependent we should be on the nebulized medications as the primary route of administration for severe respiratory distress. We should also look at the SQ beta-agonists and IV steroids. Mark At 12:31 AM 10/28/99 -0500, you wrote: >Mark, > >Just a thought - why do we give albuterol at all in any patient? If >albuterol is absorbed by the mucus membranes, then when we give albuterol >by a nebulizer, it should be absorbed by the mucosa in the mouth and upper >airway. If we give it thorugh the ET tube, then it is bypassing the mouth >and trachea - so theoretically, more should be available to be absorbed in >the lower airways. BTW, in the ICU where I work, we routinely give >albuterol treatments to vent patients - using an in-line nebulizer. Also, >see my post to Gene regarding a device to give albuterol by BVM. > *********************************************************************** Mark E. A. Escott, LP (713)737-5785 Office EMS Director (713)527-6000 Office Lecturer (713)285-5156 FAX Human Performance and Health Sciences (281)397-3991 Pager Rice University (713)412-2864 Cell/VMail 6100 Main St. MS-551 fireman@... e-mail Houston, TX 77005-1892 www.ruf.rice.edu/~dispatch *********************************************************************** Quote Link to comment Share on other sites More sharing options...
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